Analytical study of mortality in Intensive Care Unit
DOI:
https://doi.org/10.18203/2349-3933.ijam20192619Keywords:
Mortality causes, Multi organ failure, ICUAbstract
Background: Intensive care Unit is the one place where we come across various medical critical cases and high number of deaths is also recorded here. In spite of so many deaths occurring at this unit, cause of death is poorly reported. We studied the different causes for deaths in ICU which includes single and multiple factors for cause of death.
Methods: A retrospective study performed between January 2017 to January 2018 at Rajiv Gandhi Institute of Medical sciences, Kadapa, Ongole, A.P. This study includes 260 deaths among patients admitted in ICU of our institute during this duration. We gathered data at various levels like clinical evaluation and investigations.
Results: A total of 260 deaths were recorded during this study. Among these 215 (82.69%) are female and 45 (17.30%) are male. At the time of death 174 (66.92%) patients has single systemic cause 86 (33.06%) had more than one systemic cause. Cardiovascular death 50 (19.23%) is the most common cause of death among all in which CAD 28 (10.76%) are major portion and congestive cardiac failure 20 (7.6%) are the remaining portion of the cardiac deaths. Chronic kidney disease 37 (14.2%) is the next highest deaths recorded and cerebro vascular 35 (13.46%) deaths follows the next in line.
Conclusions: Majority of ICU patients were present with at least one organ failure at the time of death. What we have concluded in this study is that there are more number of deaths with single systemic cause than multiple systemic causes.
References
Jigeeshu V. Divatia, Pravin R. Amin,Nagarajan Ramakrishnan, Farhad N. Kapadia,Subhash Todi et al Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study, Indian J Crit Care Med. 2016 Apr;20(4):216-25.
Karnad DR, Lapsia V, Krishnan A, Salvi VS. Prognostic factors in obstetric patients admitted to an Indian intensive care unit. Crit Care Med. 2004;32:1294-9.
Krishnan A, Karnad DR. Severe falciparum malaria: An important cause of multiple organ failure in Indian intensive care unit patients. Crit Care Med. 2003;31:2278-84.
Ferreira FL, Bota DP, Bross A, Mélot C, Vincent JL. Serial evaluation of the SOFA score to predict outcome in critically ill patients. JAMA. 2001;286:1754-8.
Vincent JL, Marshall JC, Namendys-Silva SA, François B, Martin-Loeches I, Lipman J, et al. Assessment of the worldwide burden of critical illness: The intensive care over nations (ICON) audit. Lancet Respir Med. 2014;2:380-6.
Pavon A, Binquet C, Kara F, Martinet O, Ganster, F Navellou JC, et al. Epidemiology of Septic Shock (EPISS) Study Group: Profile of the risk of death after septic shock in the present era: An epidemiologic study. Crit Care Med. 2013;41:2600-9.
Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, et al. Sepsis Occurrence in Acutely Ill Patients Investigators: Sepsis in European intensive care units: Results of the SOAP study. Crit Care Med. 2006;34:344-53.
Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991;100:1619-36.
Braber A, van Zanten AR. Unraveling post-ICU mortality: predictors and causes of death. Eur J Anaesthesiol. 2010;27(5):486-90.
Mayr VD, Dünser MW, Greil V, Jochberger S, Luckner G, Ulmer H, et al. Causes of death and determinants of outcome in critically ill patients. Crit Care. 2006;10:R154.
Omar MA, Aram FO, Saeed N, Banafa MB. Causes of mortality among critically ill patients admitted in intensive care unit. Bahrain Medical Bulletin. 2015 Sep;37(3).
Orban JC, Walrave Y, Leone M, Allaouchiche B, Lefrant JY, Constantin JM, et al. Causes and characteristics of death in ICU: a national study. Intensive care medicine experimental. 2015 Dec;3(1):A770.
Strand K, Walther SM, Reinikainen M, Ala-Kokko T, Nolin T, Martner J, et al. Variations in the length of stay of intensive care unit nonsurvivors in three Scandinavian countries. Critical care. 2010 Oct;14(5):R175.
Garland A, Olafson K, Ramsey CD, Yogendran M, Fransoo R. Distinct determinants of long-term and short-term survival in critical illness. Intensive Care Med. 2014;40:1097-105.
Chen YC, Lin SF, Liu CJ, Jiang DD, Yang PC, Chang SC. Risk factors for ICU mortality in critically ill patients. J Formosan Med Association. 2001 Oct 1;100(10):656-61.
Moitra VK, Guerra C, Linde-Zwirble WT, Wunsch H. Relationship between ICU length of stay and long-term mortality for elderly ICU survivors. Crit Care Med. 2016 Apr;44(4):655-62.
Mani RK. End-of-life care in India. Intensive Care Med. 2006;32:1066-8.
Lesieur O, Leloup M, Gonzalez F, Mamzer MF. EPILAT study group: Withholding or withdrawal of treatment under French rules: A study performed in 43 intensive care units. Ann Intensive Care. 2015;5:56.
Parikh CR, Karnad DR. Quality, cost, and outcome of intensive care in a public hospital in Bombay, India. Crit Care Med. 1999;27:1754-9.
Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: A systematic review. JAMA. 2002;288:2151-62.
Prayag S. ICUs worldwide: Critical care in India. Crit Care. 2002;6:479-80.